A Canadian in South Africa

9th generation Union College Minerva Fellow from Ottawa, Canada working with A FRESH Start at Witkoppen Health and Welfare Centre in Johannesburg, South Africa with the primary goal of preventing mother to child transmission of HIV. To learn more about the...

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One Week to Go

It’s hard to believe that I need to start saying my goodbyes and packing the incredible amount of stuff I have here in my tiny room. I am not looking forward to my 26 hour trip to Montreal in a cramped economy class airplane seat, but I am certainly looking forward to getting home and seeing my friends, family, and dog. When looking back on my time here, I will not miss the security walls, the 12-passenger taxis cutting me off at every traffic light, the embarrassment of my Canadian debit card getting declined at the grocery store, or the never-ending search for good wifi. This country definitely has its problems. The headlines in the news seem to always be about the problems, and everyone likes to talk about what’s wrong. Hidden beneath the headlines, however, is unbelievable beauty, kindness, and perseverance. While travelling, I have been in awe by scenery and wildlife I never thought these eyes would see. I have also met so many unbelievable people who have touched my life and whom I will never forget. Some of you may know who you are, and others may not. I have met people who have given me a home away from home, who have gone out of there way to make sure my time here in their country was enjoyable and unforgettable. To these people I will forever be thankful and I will never forget what they have done for me. I truly hope I can one day return the favour. I have also met many people who have touched my life in a way they may not understand. People who may look like, in the stereotypical sense, unsuccessful and unimportant. People who struggle to get by on a daily basis, who lack education, who are diseased and struggling with their health, and who have children they give everything they have to support. Although many people in society look down on them, I look up to them. I don’t know if I could make it through one day living in their shoes let alone a lifetime. I salute these people and I hope that one day I can be half as resilient and perseverant as them. Niyabonga/Dankie/Thank you, South Africa, I hope we meet again soon. 

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The HIV Stigma

Since I have been with A FRESH Start, one of my main accomplishments has been organizing an HIV support group for our mothers. Something as simple as support is regularly taken for granted. In South Africa, over 7 million people are currently living with HIV, 4 million of whom are women above the age of 15. The reality in the African culture is most of these women are married and have children. It is easy to assume, since there are so many people and women living with the disease, that there is no stigma associated with it. South Africans should be accustomed to people having HIV, and they should accept them for who they are right? Unfortunately that is still not the case, and people battle everyday to hide their HIV positive status from friends, family members, and partners. They feel they will be rejected from their social network due to their HIV status. Mothers are often scared of being kicked out of their house, as their husbands will think they brought the virus into their household. Sometimes this is true, and other times the mothers are simply fearing the worst. As a result, they do not take their medication, and they live in constant stress.

There were 180,000 AIDS related South African deaths in 2015, and I am very confident that a large amount of them were due to stigma. This epidemic could be conquered if everyone was willing to accept and understand HIV. With religious adherence to antiretroviral (ARV) treatment, people are able to ‘put the virus to sleep’ and the virus becomes almost impossible to transmit. The ARVs also give a person a normal lifespan and allow people to lead healthy lives. As it is, however, people are too afraid to test for HIV, they are too afraid to accept themselves as HIV patients, and they are too afraid of others not accepting them for who they are. The epidemic continues to impact people’s lives as well as their loved ones’. 

The goal of the HIV support group is to allow mothers to conquer the HIV stigma, to educate them about the realities of HIV, and to bring mothers together whom are living in similar situations. It has been great to see the mothers profiting and enjoying the support. I asked a mother today how she’s enjoying the group, and she said, “I really enjoy it, I feel safe with these women, like I can share anything, it has relieved my stress”. Thanks in large to the support group, another mother recently told her mother about her HIV status, and to her surprise, her mother accepted the news very well. 

On a personal level, it is difficult to understand what these mothers are going through. I have never been faced with such stigma in my life and I cannot begin to understand what they feel on a daily basis. One thing is for sure, however, bringing them together gives them hope. It helps them, their family, their community, and South Africa in general. Although the group is very small in comparison to the 7 million infected people, we need to impact people one at a time. Educating and supporting one person also impacts others, and so on and so forth. Together we can make a difference with the tools and knowledge we have, and slowly put this epidemic to rest.

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One Day at a Time

I am over 2/3 of the way done my Minerva Fellowship in South Africa with only 2 and a half months remaining. I have been asked many times in the past few weeks, “how do you like South Africa?”, “how has your experience been?”, “do you miss home?”. Although I have now answered it many times, it never seems to get easier, and I’m never really satisfied with my answer. The truth is, I am now settled in here and everyday just seems like a normal day. I no longer have the culture shock that I experienced in my first months, where going to the mall was stressful and overwhelming. My experience no longer really feels like an experience. Of course, I am always experiencing new things, but I see them as small experiences amidst my usual day. I cannot say that I am now South African by any means, but I am finally feeling like I fit in. I have a great routine of going to work, going to the gym, playing golf, and meeting friends, which gives me things to look forward to, yet not too far ahead. I miss my home, but I know I have a job to do here and I need to make the most of it until it is my time to leave. Projects are finally taking shape at the clinic, and it feels like I am making a difference. 

Therefore, my answer is quite simple: my time here has been great, i’ve really enjoyed South Africa, but I am taking it one day at a time. At the end of the day, that’s all we can ever do. 

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Today, December 1, marks World AIDS Day, and what better place to spend it than in a South African clinic helping the area at the epicentre of the epidemic. Witkoppen Health and Welfare Centre held a ceremony commemorating those who are affected by HIV as well as those who have fought and died due to the deadly virus. One of the speakers at the ceremony mentioned how she and one other doctor were the first at Witkoppen to treat HIV, holding HIV clinics on Tuesdays and Thursdays about 30 years ago. At this time, there was no treatment for HIV. As she mentioned, they would treat complications such as tuberculosis and pneumonia, but after a short amount of time, all patients would die. She said it was the most difficult time of her career. 

Today, patients and doctors are far more fortunate. Doctors are able to prescribe treatment that, if taken on a regular basis, will allow patients to live normal lives. Adhering properly to the medication almost completely takes away the possibility of transmitting the virus to partners and children. It was also announced yesterday that trials will begin in 20 months on 5,400 HIV negative volunteers for an HIV vaccine. This may be a huge step towards preventing new HIV cases, which are said to happen at a frequency of 1,000 times per day here in South Africa. 

Furthermore, a new initiative by UNAIDS for South Africa has been put in place called 90-90-90 by 2020. This means that the goal by 2020 is: 90% of people should know their HIV status, 90% of those whom are positive should be on treatment, and 90% of those on treatment should be virally suppressed. Currently, 66% of South Africans know their status, of those who do know they are positive, 55% are on treatment, and 87% are virally suppressed. Therefore, their is still a huge issue and 90-90-90 will be difficult to achieve.

For people living in the Western world, it is difficult to understand why people wouldn't get tested or get treatment once diagnosed. It improves your everyday life, prolongs your lifespan, protects you from other diseases, and protects those around you. The issue is, African culture is completely different, and so are the living environments. Many people have no money, are not educated about the facts or are afraid of the stigma that comes along with HIV. For example, a woman will test positive for HIV but will not disclose to her partner. The reason for this is the partner will blame her for bringing the HIV into the household, and may beat her or throw her out onto the street. Of course, the truth is that many times the men are bringing HIV into relationships, putting young girls in particular danger. Nevertheless, the woman will not take her medicine because she does not want her partner seeing the pills and figuring out she is HIV positive. This not only puts both of them in danger, but it also puts their children in danger, especially if the mother is breastfeeding. 

Luckily, there are programs like A FRESH Start which educate, test, support, and protect babies from this outcome. Unfortunately, however, there are times when it is out of our control. Witkoppen currently treats about 350 children with HIV, some with mothers in care and others without. These innocent children have been infected before really having been given a chance in life. It breaks my heart to see these kids at such a young age having the health complications they must endure due to the infection. To make things worse, many of their parents or guardians cannot afford to have them come to the clinic anymore due to a fee increase at the clinic. Up to date, the children have been able to get care even if their caregivers were unable to pay. Beginning in January, however, everyone will have to pay to be treated or else sent away. This means that children would have to attend a government clinic where free care is available. The issue is that these clinics do not have adequate resources to treat paediatric HIV patients and they would be in great danger. It really does not seem fair to me. Healthcare is a human right, especially for an HIV infected child. 

As a result, I am working with Lauren Cohen (founder of the Gift of Hope and A FRESH Start), Dr. Holly France (Paediatric HIV specialist), and other staff members to accommodate the mothers and children who cannot afford to come to the clinic anymore. Although it is hard to imagine for most of us, believe me when I say these people literally live on the bare minimum. Many rely on monthly income that couldn’t buy me 3 meals at McDonald’s, let alone support a family. 

Please visit this link (http://www.giftofhopeusa.org/goh-oursuccessstories-lerato-and-nyiko.shtml) and read about Lerato and Nyiko (pictured above), two patients whom I see frequently at the clinic. This will give you an understanding of what these patients are going through, and how you can help them. If you have any questions please let me know, and if you know anyone who is looking to make a difference in someone’s life, please share this with them. 

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Hello everyone! Sorry for not posting in a while, but I have been very busy working a number of different projects for A FRESH Start with the calendar year coming to an end. I will be updating you on these projects when the time is right, but for now I would like to write about the beauty of South Africa. 

I was fortunate enough to gain two travelling buddies for two weeks as my parents landed in Johannesburg on October 28th. I hadn't been very far outside of the city since I had been here, and it was a great opportunity to explore the rest of the country. 

We started our tour in Pilanesberg, a National Park about 2 hours north of Joburg. We stayed in a beautiful lodge on the edge of the park for 2 nights and took part in game drives into the park early in the morning and late in the afternoon. This is something neither of us had ever experienced as we got to see lions, leopards, baboons, elephants, giraffes, rhinos, hippos, and many other African animals in their natural habitats for the first time. It really never gets old being in the wild and observing these beautiful creatures. The temperature would get up to 39 degrees celsius (102 F) but we had no issue relaxing by the pool during the day until it cooled off.

We then flew from Johannesburg to Port Elizabeth, located on the coast of the Indian Ocean. From there we began travelling south-west along coast on a famous route known as the ‘Garden Route’.  We stayed in 3 different places along the way, and all of them were spectacular! There are so many things to do from fishing, golfing, exploring animal, plant and bird sanctuaries, or simply relaxing by the beach and enjoying the ocean. Even driving was an amazing event, as we could look around at the beautiful countryside or down the cliffs of the ocean. 

Our last stop was in Cape Town, perhaps the most beautiful city I have ever seen. Everywhere you go, you can turn around and look up at Table Mountain (one of the natural wonders of the world) and on the other side you have the Atlantic Ocean. We, explored the city, made our way to Cape of Good Hope (the most south-western tip of Africa), and travelled to the wine lands to get a taste of the world-famous Cape Town wine. If you ever get the chance to visit this city, make sure you do!!

Overall, I don’t know if I have ever seen more wildlife and beauty in my life. I feel very fortunate for the opportunity to have such an experience, and to also have such great parents whom are willing to support me and come visit. Every place we visited seemed to be slightly different yet just as amazing and beautiful as the previous one. When reflecting back on the trip, neither of us could decide which part of the trip was the best, as it was all so good. 

At the same time, however, this beauty is still surrounded by poverty, crime, and corruption. Although I have become accustomed to this, I know my parents felt uneasy at times walking the streets or even travelling by car, especially at night. It is very unfortunate that a place with so much to offer must be surrounded with so many issues. Issues such as animal poaching, lack of education, theft, and unemployment are only a few that constantly seem to be hovering around like a fog. To put this into perspective, I mentioned that Cape Town is one the most beautiful cities I have seen, yet it is ranked #9 in the world for murder rate per capita. 

Luckily, none of this affected our trip, and we had an unforgettable experience! I am looking forward to my brother, Nigel, visiting at Christmas so we can explore more of the country together. I’ve tried to keep this short, as I could have gone on much longer about how great the trip was and what exactly we did. I hope you are all well in Canada, USA, or wherever you are reading from, and I miss you all. Thank you for reading, I hope you’ve enjoyed my blog so far, and I will be posting again before long. 

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Last week I helped organize and I took part in A FRESH Start Community Wellness Day. A community wellness day entails bringing services into the community so people are able to access basic healthcare needs without having to travel to a clinic. This lowers costs due to transport, time away from work, and the services we offer are free. The services offered were: HIV testing and counselling, pregnancy testing, immunizations, family planning (contraceptives), blood pressure and blood glucose testing. Along with the DREAMS team and the mobile clinic from Witkoppen Health and Welfare Centre, we set up stations in the tents and truck shown in the pictures above. 

The outreach event was stationed in a suburb of Johannesburg called Kya Sands. This is an informal settlement area also known as a shanty town. For the most part, people in these townships find a place to build a house/shack and make due with whatever they can. There are 189 registered informal settlements in the City of Johannesburg. A survey performed in 2014 showed that only 25% of people in Kya Sands were employed. For obvious reasons, this is a huge barrier impeding residents from receiving proper healthcare and living a healthy lifestyle. We stationed the outreach at a soccer field about 50 meters into the township. The pictures shown all illustrate this field, and as you can see it isn’t much of a field compared to many of our standards. The one picture shows children playing soccer in the distance, most of whom are playing barefoot. 

The day was a great success, in my opinion. As soon as we set up the tents and the tables, patients lined up and the line did not stop until it was time to leave. In fact, we had to turn away some patients and return the day after to ensure we gave everyone a chance to be tested. Men, women, and children of all ages came by to use the services provided. 

Although it has been very rewarding for me helping these people, it has also been difficult morally. For example, I was testing a woman’s blood pressure, and it came out to be quite high. I asked her if she was feeling okay since her blood pressure was so high. She said she is very stressed these days because she has children at home and both she and her husband cannot find employment. The issues I’ve seen stem far deeper than simple healthcare needs. Although I am able to provide basic healthcare needs to these people, I am unable to help them find jobs or fund their education. I can easily say “you should drink more water, and eat healthier food, but I know they have no way of doing so. Everyday for these people is a struggle we are fortunate enough to say we will never have to experience. 

There are so many people with these kinds of issues, that a person like me finds it very overwhelming because I would love to help them all, and it hurts me to see them living like this. Realistically, there is only so much I can do. My hope is that I can help them as much as possible, and others can do the same in their own capabilities. A FRESH Start is giving many families and individuals the chance to live healthy lives, and others need to follow suit. The issues are large and multifaceted and we need to come together to fight them. The patients we see are very thankful for A FRESH Start, and I am very proud to be apart of this program. 

Days such as these have allowed me to see the world from a different perspective, and have shown me that nothing should ever be taken for granted. 

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Some may think that success stories are hard to come by when working in an health clinic with a large number of HIV positive patients. HIV is a lethal virus that has many negative impacts on a person’s life as well as their family’s. The truth is, however, that most of these mothers are success stories. The way they are able to cope with such adversity and raise their children despite their financial, mental, and physical issues. Everyday I have worked with these patients in the clinic and in the community has been awe inspiring. To see first-hand what these people go through on a daily basis never ceases to amaze me, and it certainly makes my troubles look very minor in comparison. 

This picture is an example of the incredible sacrifice that people make for their family members, as well as the impact that A FRESH Start can provide for children in Johannesburg. The woman shown on the left is the grandmother of the young boy on her back. Her daughter has given birth to 5 children, and this boy is the only one living HIV-free. The eldest has since passed away due to complications of the virus and the mother was not feeling well enough to make the trip to the clinic for her child’s routine visit. Therefore, the grandmother has stepped in to help care for the children, travelling long distances by foot and by taxi to ensure this baby remains HIV-free. A FRESH Start has given this child the chance to live life without HIV.

The woman shown on the right is A FRESH Start’s health educator Dikeledi Mahlowa. She has been a member of the team for the past 2.5 years, and is another reason why children such as this one can start life on the right foot. As you can see by the picture, she is extremely caring and passionate about her job and the patients she works with. As she has told me, “If you were to ask me about A FRESH Start, I could tell you about it in my sleep, I love this program”. 

The last component of this picture I wanted to mention is the clothes and diapers sitting on the table. These are generous donations given to me by members of my community. I would sincerely like to thank my family members, friends, my mother’s coworkers, as well as Boomerang Kids in Ottawa for the generous donations of baby and women clothes. I originally began asking for donations in hope that I could get some clothes to help out a little bit. I ended up filling a hockey bag with donations and still did not have enough room for everything I received. It was quite the task hauling all of these donations on top of my luggage and golf clubs (yes my golf clubs were necessary) from Ottawa to Johannesburg, but it was well worth it since I get to distribute them to deserving people such as this grandmother and child. 

In my short time here, I have been humbled and awed by sacrifice, struggle, dedication, and success. Although some may think that these contrasting ideas may not possibly coexist, I can tell that they can, and they are in front my very eyes. 

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When looking at these two pictures, it is hard to believe they can coexist in the same area, but in fact they are less than a five minute drive from each other. When people ask me, “what is the biggest difference between Canada/America and Johannesburg?”, these sort of pictures are what come to mind.  

The first picture shown is an aerial view of Steyn City, a 900 hectare man made ‘city’ only a 2 minute drive from Witkoppen Health and Welfare Centre.  It was built by Douw Steyn, a South African businessman worth somewhere around R8 billion.  That building shown is his R150 million house built in the middle of the city which also includes about 33 cars in his garage. The city also includes a shopping mall, a world-class golf course, as well as other commodities only available to those that live within the complex. Just to commence the building of the city, R6 billion was dispensed. 

When you drive down the road that Witkoppen is on, you will pass Steyn City, and you will see its 20-30 foot walls surrounding it. The separation it creates is quite clear since you literally cannot see the other side of the wall. If you continue 5 minutes down the same road, you will get to Diepsloot, the 12,000 hectare township shown in the second picture. I must add, this only illustrates a section of Diepsloot, and not all of the residents reside in shacks such as those shown. Nevertheless, many of the patients and staff at Witkoppen reside in Diepsloot, and must pass by Steyn City everyday they make their way to the clinic. 

I am not posting this to judge right or wrong, because I am not entitled to that sort of opinion and I do not know enough about the facts to state an opinion. I am simply trying to illustrate some contrast in what is seen here everyday. All I know for a fact is that where I am from, this contrast and disparity cannot be observed.

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As some of you may know, August is women’s month, and from August 1-7 is World Breastfeeding Week. I assisted A FRESH Start Health Councillor Dikeledi (seen on left) in leading Exclusive Breastfeeding presentations to future mothers of the Antenatal Clinic at Witkoppen Health and Welfare Centre.  Just to clarify a couple of terms, antenatal means before birth (during pregnancy) and Exclusive Breastfeeding (EBF) is the notion that only breast milk will be given to the baby from birth until 6 months. If the mothers have the choice, it is very beneficial for them to breastfeed as supposed to using formula through a bottle. It drastically decreases the baby’s risk of disease, increases the baby’s overall health, and decreases their financial burden since, well, breast milk is free! When I say “given the choice”, there is a common misconception that HIV+ mothers cannot breastfeed. In fact, as long as their viral loads are suppressed through good health and antiretroviral drugs (ARV), they are free and safe to breastfeed without transmitting the virus. The issue is, however, the women either don’t understand this, don’t know their viral loads as they give birth, or are being told by someone else (partner, parents, community members) that it isn’t safe to breastfeed. Therefore it is crucial that we transmit the information to them to help them understand as well as have them visit clinicians so they can be aware of their viral loads before they give birth. This is essential since once they begin formula feeding, they can no longer return to breastfeeding. If they start the bottle feeding before their first postnatal visit to the program, it is already too late! So far it has been a great experience working with the unbelievable staff of A FRESH Start and the perseverant patients that we see. As you can see by the picture, despite their hardships, they always find a way to smile.

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Day 1

After over 24 hours of traveling, I've finally made it to Johannesburg, South Africa! After 4 months of thinking and wondering what it would be like, I can finally see it for myself. The weather is beautiful today, with not a cloud in the sky and a high of about 20 degrees Celsius or 68 Fahrenheit. I see many of the locals wearing scarves, toques, and warm jackets whereas I got off the plane with nothing but shorts and a t-shirt on. This is winter in South Africa and I will admit it gets quite chilly at night once the sun goes down. It will be getting much hotter and I will enjoy this kind of weather while I can. So far I have noticed many things that have taken me off guard. First off, there are so many nice cars here. The airport parking lot was full of expensive cars and driving along the highway I saw many fancy, expensive car dealerships. In the complex I live in, I've seen more Range Rovers than I've ever seen and I met a Ferrari coming into the neighborhood earlier this morning. Staying on the topic of cars, driving on the left hand side of the road takes a lot of getting used to. I can't say I am completely comfortable after my first day but I am catching on pretty quickly. Another thing that I noticed today was the desperation for employment in Johannesburg. It seems impossible to stop at a red light or in a parking lot without being offered a service or merchandise of some kind. Today I was offered furniture, contracting, a CD mixtape, phone chargers, AUX cables, and car washes all while in my car. Unemployment rate is so high that people need to create jobs. There are parking guards in most parking lots to help you park and guard your car. Although it may not seem very useful to me, it creates a job for somebody who may not have one otherwise. Although I did not get a whole lot accomplished today by my usual standards, simply soaking everything in and finding my way around was enough of a shock to tire me out. Not to mention I've barely slept in the last 2 days (I'm a terrible sleeper, especially on planes). I'm really looking forward to getting to know this area and this country, it has already fascinated me. I'd also like to take this opportunity to thank everyone that made my time at home so enjoyable. I'm going to miss everyone over the next 9 months. Thanks also to all those who have reached out and who have taken time to wish me luck. Happy Friday, I hope everyone has a great weekend wherever you may be!

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T-Minus 1 month!

I am scheduled to fly from Montreal to Johannesburg on July 20, finally getting my Minerva Fellowship underway!  It has been a long, exciting few months of preparation and I am very excited to get started.  Probably the question that I have been asked the most since I’ve been awarded the position is “Are you nervous?”.  I don’t know if that means that I should be nervous, but I’m really not.  Of course there is always the uncertainty that lies with such an opportunity since I have never been outside of North America and I have definitely never lived in an area of such poverty and apartheid.  For me, however, I see it as nothing but a tremendous opportunity.  As Muhammad Ali once said, “A man who views the world the same at fifty as he did at twenty has wasted 30 years of his life”.  Having grown up a hockey player, my life has been surrounded by the sport and the constant pressure to become a stronger hockey player.  Now that I am done with the sport competitively, I am excited to experience the world in a different way.  I can’t wait to embark on a new journey, meet new people, see new things, and help those in need along the way.  I must admit that until I heard about the fellowship late last year, I had never thought about doing such a thing.  Now that I have been exposed to this new idea, it has certainly changed my life for the better.  Nothing to be nervous about if you ask me.